When to Have Total Knee Replacement Surgery

Like any surgery, a total knee replacement presents risks. It also involves a long recovery and rehabilitation process.

Although surgeons perform an estimated 700,000 total knee replacements (TKRs) in the United States each year — and the annual number is expected to rise significantly by 2030 — the decision about whether or not to proceed with a knee replacement remains both personal and practical.

Many patients put off a TKR until pain and mobility problems become unbearable. It often takes time to come to terms with needing a knee replacement. Surgery is, after all, a big deal. At first, you may hope that less invasive treatment options will help your knee improve and render surgery unnecessary.

And, of course, it’s wise to exhaust all other treatment methods and therapies before undergoing a TKR. You first may want to consider lifestyle changes, the use of medication and injections, strengthening exercises, alternative treatment methods such as acupuncture, and other surgical procedures, including arthroscopy (although arthroscopy has little to offer for arthritis).

However, it’s possible that even after you’ve tried all these other options, your doctor will still recommend a TKR.

Prior to recommending a TKR, an orthopedic surgeon will conduct a thorough examination of your knee using X-rays and possibly an MRI to see inside of it. They will also go over your recent medical history to determine whether or not the TKR is necessary.

Delaying or declining a TKR after your surgeon has recommended the procedure can have serious repercussions. For example, it can lead to:

deformities outside the knee joint

weakened or lost function in muscles and ligaments

greater difficulty or an inability to engage in normal daily activities—including walking, driving, and bathing—due to chronic pain and a loss of functionality (which could result in a further reduced quality of life and a negative impact on your emotional well-being)

complications down the road, which may require surgery eventually

Continued use of your damaged joint will likely lead to further deterioration and damage, making a future procedure more complex. In addition, longer procedures require more time under anesthesia, which further increases risk. In fact, surgeries performed earlier have higher success rates, and recipients are able to function more effectively in the months and years ahead.

There’s no exact method for determining when a TKR should be performed. And it’s important to understand that because of age, weight, medical conditions, or other factors, some individuals simply aren’t candidates for the procedure. But if you fall into the category of someone who might benefit from a TKR, consult with a surgeon and, if necessary, get a second opinion. Your future health and lifestyle may be riding on it.